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Effect of Scheduling a Post-Discharge Outpatient Mental Health Appointment on the Likelihood of Successful Transition From Hospital to Community-Based Care
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Overview
Scheduling an outpatient mental health appointment is a recommended discharge planning practice, but little is known regarding effectiveness. Learn more here.
ABSTRACT
Objective: This study examined a cohort of 15,520 inpatient psychiatric discharges to determine associations between scheduling an outpatient mental health appointment as part of discharge planning and attending outpatient care following discharge after control for patient, hospital, and system characteristics.
Methods: 2012–2013 New York State Medicaid and other administrative databases were used to examine patients who were aged under 65 years, admitted to an inpatient psychiatric unit, and discharged to the community. Outcomes included attending an outpatient mental health service within 7 and 30 days following inpatient discharge. Scheduling a mental health outpatient appointment as part of the discharge plan was the primary predictor variable, and potentially confounding covariates were addressed by adjusting for propensity scores estimating the likelihood of having an outpatient appointment scheduled.
Results: Among 15,520 discharged patients, 11,945 (77%) had an outpatient appointment scheduled with a mental health provider as part of their discharge planning. After adjustment for propensity scores, patients who had an outpatient appointment scheduled were significantly more likely to attend an outpatient mental health service within 7 (OR = 1.69; 95% CI, 1.48–1.94) and 30 days (OR = 1.65; 95% CI, 1.42–1.93) compared to patients who did not have an appointment scheduled. Even among those with a low propensity to have an appointment scheduled, scheduling an outpatient appointment was associated with attending outpatient services.
Conclusions: Scheduling an outpatient mental health appointment is an effective and low-resource discharge planning practice that should be an important target for inpatient psychiatric clinical quality measurement and improvement.
To cite: Smith TE, Haselden M, Corbeil T, et al. Effect of Scheduling a Post-Discharge Outpatient Mental Health Appointment on the Likelihood of Successful Transition From Hospital to Community-Based Care. J Clin Psychiatry 2020;81(5):20m13344.
To Share: https://doi.org/10.4088/JCP.20m13344
Read the whole article at psychiatrist.com here:
Effect of Scheduling a Post-Discharge Outpatient Mental Health Appointment on the Likelihood of Successful Transition From Hospital to Community-Based Care
© Copyright 2020 Physicians Postgraduate Press, Inc.
Target Audience
Psychiatrists
Learning Objectives
Schedule follow-up mental health appointments as part of the standard of care for inpatient psychiatric discharge planning
CME Background
Articles are selected for credit designation based on an assessment of the educational needs of CME participants, with the purpose of providing readers with a curriculum of CME articles on a variety of topics throughout each volume. Activities are planned using a process that links identified needs with desired results.
To obtain credit, read the article, correctly answer the questions in the Posttest, and complete the Evaluation. A $10 processing fee will apply.
CME Objective
After studying this article, you should be able to:
• Schedule follow-up mental health appointments as part of the standard of care for inpatient psychiatric discharge planning
Statement of Need and Purpose
Scheduling follow-up mental health appointments is an accepted standard of care for inpatient psychiatric discharge planning, and there is no rationale for not completing this routine practice. Discharge planning practices that promote successful care transitions should be key focus areas for clinical quality measurement and improvement activities.
Release, Expiration, and Review Dates
This educational activity was published in September 2020 and is eligible for AMA PRA Category 1 Credit™ through October 31, 2022. The latest review of this material was August 2020.
Disclosure of Off-Label Usage
The authors have determined that, to the best of their knowledge, no investigational information about pharmaceutical agents or device therapies that is outside US Food and Drug Administration–approved labeling has been presented in this activity.
Funding/Support
Research supported by a grant (R01MH106558) from the National Institute of Mental Health (NIMH).
Role of the Sponsor
NIMH had no role in the conduct and publication of the study.
Disclaimer
The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Faculty Affiliation
Thomas E. Smith, MD*
New York State Psychiatric Institute, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
Morgan Haselden, BA
New York State Psychiatric Institute, New York, New York
Tom Corbeil, MPH
New York State Psychiatric Institute, New York, New York
Melanie M. Wall, PhD
New York State Psychiatric Institute, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
Fei Tang, MPH
Office of Performance Measurement and Evaluation, New York State Office of Mental Health, Albany, New York
Susan M. Essock, PhD
Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
Eric Frimpong, PhD
Office of Performance Measurement and Evaluation, New York State Office of Mental Health, Albany, New York
Matthew L. Goldman, MD
Department of Psychiatry, University of California–San Francisco, San Francisco, California
Franco Mascayano, MPH
New York State Psychiatric Institute, New York, New York
Marleen Radigan, DrPH
Office of Performance Measurement and Evaluation, New York State Office of Mental Health, Albany, New York
Matthew Schneider, MD
Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York
Rui Wang, MS
Office of Performance Measurement and Evaluation, New York State Office of Mental Health, Albany, New York
Lisa B. Dixon, MD
New York State Psychiatric Institute, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
Mark Olfson, MD
New York State Psychiatric Institute, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
*Corresponding author: Thomas E. Smith, MD, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032 ([email protected]).
Financial Disclosure
All individuals in a position to influence the content of this activity were asked to complete a statement regarding all relevant personal financial relationships between themselves or their spouse/partner and any commercial interest. The CME Institute has resolved any conflicts of interest that were identified. In the past year, Marlene P. Freeman, MD, Editor in Chief of The Journal of Clinical Psychiatry, has received research funding from JayMac and Sage; has been a member of the advisory boards for Otsuka, Alkermes, and Sunovion; has been a member of the Independent Data Safety and Monitoring Committee for Janssen; has been a member of the Steering Committee for Educational Activities for Medscape; and, as a Massachusetts General Hospital (MGH) employee, works with the MGH National Pregnancy Registry, which is sponsored by Teva, Alkermes, Otsuka, Actavis, and Sunovion, and works with the MGH Clinical Trials Network and Institute, which receives research funding from multiple pharmaceutical companies and the National Institute of Mental Health. No member of the CME Institute staff reported any relevant personal financial relationships.
Drs Smith, Wall, Essock, Frimpong, Goldman, Radigan, Schneider, Dixon, and Olfson; Mss Haselden, Tang, and Wang; and Messrs Corbeil and Mascayano have no personal affiliations or financial relationships with any commercial interest to disclose relative to the article.
Accreditation Statement
The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Credit Designation
The CME Institute of Physicians Postgraduate Press, Inc., designates this journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.
Available Credit
- 1.00 AMA PRA Category 1 Credit™
- 1.00 Participation